Clinical Evaluation of Yashtimadhu Ghrita in the Management of Parikartika (Fissure-in-Ano): A Case Report

Parikartika is a frequently encountered and painful anorectal disorder that closely resembles fissure-in-ano. It has been described by Acharyas as a complication (Vyapad) of Vamana, Virechana, and Basti procedures. In the modern era, rapid lifestyle changes—such as sedentary occupations, increased stress, irregular dietary patterns, and disturbed sleep habits—have contributed to a steady rise in lifestyle-related disorders, including anorectal conditions. Clinically, Parikartika is characterized primarily by Kartanavat Vedana (cutting-type pain) in the Guda Pradesh (anal region). Similarly, fissure-in-ano is defined as a condition marked by severe pain and bleeding per rectum during and after defecation. The most common cause is trauma to the anal canal due to the passage of hard stools. In Ayurvedic management, Acharyas have advocated the use of Madhura, Snigdha, and Sheeta Dravyas both internally and locally. These are administered in forms such as Piccha Basti, Madhura Kashaya Dravya Siddha Basti, and Yashtimadhu Taila Basti for effective management of the condition.